Question
Hello. About a year ago, I began experiencing hip pain and numbness in my right leg at the knee. The numbness would only come on when I would be walking slowly, sometimes just a tingling sensation and other times complete numbness down to my foot. Since my teenage years, I have always experience some form of low back pain on my right side so I am used to dealing with low back pain.
Until the numbness and hip pain, I was running on my treadmill to keep in shape.
I finally after about 8 months decided to go to a chiropractor. He did an exam and took X-rays. The X-rays showed that I had 2 degenerative discs, some scoliosis, and that I had apparently suffered some form of trauma to my back at an early age.(I cannot recall or can my parents any trauma except a car accident when I was 16)The Xray also showed that my right hip was higher than my left.
The doctor started treatments ( manipulation, electro stimulation, traction and massage therapy. I met with a foot doctor who took a cast and ordered orthotics to even me out.
The doctor also told me my running days were over because I am 6' 5" tall and at the time weighed 243 due to inactivity from the pain. This was very upsetting as I truly loved running.
After a few treatments, my numbness appeared to have went away. I received my orthotics and began wearing them slowly as the foot doctor and my chiropractor advised but I started getting the numbness again. The doctor sent me for an MRI.
It showed alot of scar tissue from the childhood trauma, a buldging disc but no pinched nerve. My doctor wants to perform manipulation under anesthesia to break the scar tissue. He believes this will relieve my pain and the numbness in my leg. He also believes the orthotics could be irritating the nerve causing the numbness as my body gets used to the change.
Here are my questions.
What is your opinion on MUA and do you think it would help my condition?
With all that is wrong with my back, are my days of sports, being active, etc coming to an end?
Is running truly over for me?
Also any opinion on my story is much appreciated.
FYI- I am 35 years old. As of today, I am 228 lbs.
Thank you for any information you can give. This is a great web site. Jack

Answer
Jack,

Here are my thoughts on your situation based on the information you provided.  First, a question: what childhood trauma are you referring to?  Regardless, if the MRI shows scar tissue and that is a complicating factor, then it should be dealt with.  If you had some success with chiropractic joint manipulation in the past, then it would be a logical choice to undergo MUA, especially if you are not a surgical candidate.  I cannot comment on the technicalities of MUA since I have no formal training in it, but from the literature I've read it appears to be quite safe and, in many cases, very effective.

Your days of being active are not coming to an end.  Find doctors that will be able to find ways to treat you such that you can stay active.  If you have any scar tissue that is superficial, or in accessible muscle layers, then consider Graston Technique as a method to reduce it (see www.grastontechnique.com).   If your chiropractor has gone through the chiropractic sports diplomate program (see www.acbsp.com to find a DACBSP), then they would likely have the most training in dealing with you as an amateur athlete.  Six-five and 228 isn't that big, and hopefully you are working towards 205 with a diet that avoids processed foods, hydrogenated oils (trans fats), sweets, beer (sorry), fruit juices/sodas, and one that promotes green vegetables, lean meats and other proteins, higher fiber (40g/day minimum), and supplementation with a good quality multivitamin along with extra marine-based lipid (fish oil: a source of omega-3 fatty acids; take up to 3 grams oil/day).  You must find ways to get some form of exercise while you are dealing with the sciatica, even if it means doing upper body weight training with aerobic circuits.  You'll burn calories, aid in supporting your diet regimen, and the exercise will be good for you mentally.  Also, ANY exercise that reduces the sciatica should be promoted, and hopefully your DC has tested you on which ones reduce and which ones provoke the sciatic pains.

If you can alleviate the sciatica, whether it be from MUA or other methods, then have your chiropractor functionally test and treat deficient body regions (joints AND soft tissues), get the proper physical conditioning, and be sure that your shoes and orthotics are properly fit, I cannot imagine you not being able to run unless you have more going on than what you've described to me.  

Lastly, regarding your orthotics, it is my opinion that when you step into them you should have an immediate feeling of comfort and support.  I believe they should be matched to your foot and body type, with a soft/mushy foot taking a more rigid orthotic, and a stiff and/or high-arched foot taking a softer orthotic ('just my personal opinion). I also believe that even with a more rigid orthotic there should be enough flexibility to allow your foot to roll through its normal mechanics in a back-to-front (sagittal plane) direction as you run.  Very rigid orthotics will not allow these normal running/gait mechanics.  And, while some doctors will make the orthotics to fully correct postural faults in the foot, too much correction can be intolerable to a body that has adapted to its posture for many years or decades.  

I hope this was helpful,

Dr. G
www.drgillman.com